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Unusual CNS infection from a subtorcular dermal sinus
1Department of Pediatric Neurosurgery, Connecticut Children's Medical Center, Hartford, CT, USA. pkanev@ccmckids.org
Acta Paediatrica (Oslo, Norway : 1992)
|November 17, 2009
Summary
A toddler
Area of Science:
- Pediatric Neurosurgery
- Infectious Diseases
- Medical Imaging
Background:
- Dermal sinus tracts are congenital anomalies that can lead to central nervous system (CNS) infections.
- Hydrocephalus and increased intracranial pressure are serious complications of CNS infections.
Observation:
- A 14-month-old toddler presented with symptoms of hydrocephalus and raised intracranial pressure.
- Imaging revealed a posterior fossa dermoid mass associated with a previously unrecognized dermal sinus tract.
- Cerebrospinal fluid (CSF) and subdural empyema cultures were positive for Staphylococcus aureus and Escherichia coli.
Findings:
- This case represents the first reported instance of a dermoid mass and CNS infection with Staphylococcus aureus and Escherichia coli originating from a dermal sinus tract.
- The unusual pathogens highlight the importance of considering underlying anatomical abnormalities in CNS infections.
Implications:
- Children with CNS infections involving unusual pathogens require thorough evaluation for congenital anomalies like dermal sinus tracts.
- Early identification of dermal sinus tracts can prevent severe neurological complications.
- This case underscores the need for a multidisciplinary approach in diagnosing and managing complex pediatric neurosurgical cases.
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